Which of the following best describes the mechanism of action of ezetimibe?

Ezetimibe primarily functions by reducing intestinal absorption of cholesterol. This mechanism is pivotal in managing cholesterol levels since it works specifically at the brush border of the small intestine, where it blocks the transport of cholesterol from the intestine into the bloodstream. By inhibiting the Niemann-Pick C1-like 1 (NPC1L1) protein, which is vital for the absorption process, ezetimibe effectively lowers the amount of cholesterol that enters circulation.

As a result, the reduction in cholesterol absorption leads to a decrease in overall plasma cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol. This makes ezetimibe an important component in the treatment of hyperlipidemia, often used in conjunction with statins for enhanced lipid-lowering effects.

In contrast, other mechanisms such as increasing bile acid excretion, inhibiting HMG-CoA reductase, or promoting LDL receptor uptake are associated with different classes of lipid-lowering agents. For instance, bile acid sequestrants work by enhancing bile acid excretion, statins target the HMG-CoA reductase pathway to inhibit cholesterol synthesis, and PCSK9 inhibitors work by promoting LDL receptor uptake. However, these mechanisms do not describe the action of ezetimibe